Provider Demographics
NPI:1770707002
Name:CURTIS BUCHHOLZ PC
Entity type:Organization
Organization Name:CURTIS BUCHHOLZ PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-936-3229
Mailing Address - Street 1:44455 STERLING HWY
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7936
Mailing Address - Country:US
Mailing Address - Phone:907-262-3557
Mailing Address - Fax:
Practice Address - Street 1:44455 STERLING HWY
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7936
Practice Address - Country:US
Practice Address - Phone:907-262-3557
Practice Address - Fax:907-262-6505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK 4229291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKD25199OtherUPIN
AKLB 5191Medicaid
AKK 150705Medicare PIN